Several people have told me lately how A1c results aren't all that important. I agree that A1c's aren't the ONLY lab test or number that diabetics need to be concerned over in their diabetes management. But it's also ingrained into me that A1c's are a very important number in diabetes control.

For about ten years, I went to a doctor who was directly involved in the DCCT trial. I researched the DCCT for a science fair project in 7th grade. I've seen the results. I've heard the stories. A1c results are valued by most endocrinologists in this field. Obviously, there is something to this.

For me, my A1c is one of the telling factors about my control. It's the guiding light at the end of the tunnel. There is an ultimate goal in my mind regarding my diabetes and regarding that number. It's important to me. I'd rather have a lower A1c than risk running at a higher result and increase my chances of diabetic complications.

But (there is a major but here!) my A1c isn't the ONLY thing I use to manage my strength of control. I know that the lows I have turn into a lower A1c. But just because that A1c is low, that doesn't mean that I'm not having episodes of high blood sugars and ketones. It doesn't mean that I'm lessening my risk for complications by very much.

I believe that everyone should look at the whole picture of diabetes results (A1c included!) in order to gauge how well they are managing this disease and their risk for complications. Diabetes control is about the amount of lows and highs, it's about the peaks and swings between the two, it's about the averages that the A1c shows, it's about the extent of the symptoms of both lows and highs. Diabetes isn't a one sided disease. It takes all those things to truly tell where you are on the control scale.

I know that an A1c of 7.3 isn't great. I know that the ADA and pretty much everyone else recommends A1c's below 7%. I completely agree. I think the closer a diabetic can get to the "normal" person's range, the better! But sometimes, an A1c just isn't the only test.

Since I've been on the pump, my A1c has risen in varied degrees. Before I started the pump, it was 6.9. I went to a 7.6 right after starting, then dropped to a 7.3, then 7.4, and now back to 7.3. The stability of an A1c is a very important factor. Going from a 13 to a 5 is great, but it's not that important if you don't stay there (considering it's only a three month average).

There's also the appearance of control. For me, the pump has taken my personal grasp on control of this disease. I have less daily stability. I have higher swings between the highs and lows. I stress over my averages and numbers and constantly change the pump settings just to get an A1c like 7.3%.

Unfortunately, the end results can't be seen immediately. There are only the levels of ketones in the body, the side effects of highs and lows. But those don't show whether an A1c of 6.5% will leave you with working kidneys, eyes, and a heart in the next thirty years. I just know that I'm not willing to risk throwing the A1c results out the door. I want to do everything possible to keep my kidneys and my eyes and my heart all working in the shape they are now. I want to consider every angle of this disease...the A1c, the averages, the swings, the stress...to end up healthy when I'm 65 after I've had diabetes for 61 years.